How much do the benefits cost? Effects of a home-based training programme on cardiovascular fitness, quality of life, programme cost and adherence for patients with coronary disease.
OBJECTIVE
To evaluate cost, adherence and effects on cardiovascular function and quality of life of a home-based cardiac rehabilitation programme for patients with coronary disease.


METHODS
A randomized, prospective controlled trial.


METHODS
Department of Rehabilitation, University Hospital, Brazil.


METHODS
Thirty-nine low-risk patients were assigned to a home exercise training group (n = 19) or a control group (n = 20).


METHODS
The home group performed home-based training for three months with biweekly telephone monitoring.


METHODS
The aerobic capacity and the quality of life (Medical Outcomes Study 36-Item Short Form Survey (SF-36)) of all patients were evaluated before and after the three-month period. Adherence was evaluated weekly. Programme cost was estimated using the Brazilian Classification of Medical Procedures.


RESULTS
After training, the home group had higher peak Vo2 from 28.8 (6.4) to 31.7 (8.1) mL/kg per minute, peak heart rate from 135 (22) to 143 (20) bpm, work rate from 4780 (2021) to 7103 (3057) kpm/min and exercise time from 11.5 (1.9) to 13.6 (2.3) minutes (P < or = .05). The control group showed reduction in peak Vo2 from 28.6 (6.6) to 26.8 (7.2) mL/kg per minute, peak Vo2 pulse from 15.5 (3.9) to 14.3 (3.8) mL/bpm and exercise time from 11.5 (2.3) to 11.4 (2.7) minutes (P < or = 0.05). The home group reported improvements in all domains of SF-36. The control group showed improvement in only three domains of SF-36. In the home group the average cost per patient was US$502.71 and the adherence achieved 100%.


CONCLUSIONS
The programme seems to provide an efficient low-cost approach to cardiac rehabilitation in low-risk patients.
Salvetti
Xiomara Miranda
XM
Department of Cardiology, São Paulo Federal University, Paulista School of Medicine, São Paulo, Brazil. xiosalvetti@hotmail.com
Oliveira
Japy Angelini
JA
Servantes
Denise Maria
DM
Vincenzo de Paola
Angelo Amato
AA
D000704:Analysis of Variance; D001938:Brazil; D003327:Coronary Disease / Q000191:economics / Q000534:rehabilitation*; D003362:Cost-Benefit Analysis / Q000191:economics; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D006339:Heart Rate / Q000502:physiology; D018575:Home Care Services, Hospital-Based / Q000458:organization & administration; D006785:Hospitals, University; D006801:Humans; D008297:Male; D008875:Middle Aged; D010101:Oxygen Consumption; D010349:Patient Compliance; D010809:Physical Fitness; D011446:Prospective Studies; D011788:Quality of Life; D015203:Reproducibility of Results; D012306:Risk; D016896:Treatment Outcome